{"package_id":"USCOURTS-cofc-1_07-vv-00810","decision_granule_id":"USCOURTS-cofc-1_07-vv-00810-1","petitioner_identifier":"PETER and CHERIE NUTTALL, as the legal representatives of their minor son, N.N.","is_minor":1,"age_at_vaccination":4.19,"age_unit_raw":"years","vaccine_type":"MMR","vaccination_date":"2004-11-22","condition_raw":"severe neurologic disorder, diagnosed as childhood disintegrative disorder (CDD), alleged sequela of encephalitis","condition_category":"childhood_disintegrative_disorder","autism_spectrum_adjacent":1,"outcome":"denied","award_amount_usd":null,"decision_date":"2015-01-20","extraction_version":"gemini-v2","extracted_at":"2026-04-30T04:35:36.729364+00:00","number_of_concurrent_vaccines":3,"dose_number":null,"time_to_onset_days":0,"theory_of_causation":"Petitioners alleged that N.N., vaccinated with MMR and DTaP on November 22, 2004 (age 4.19), suffered a Table Injury of encephalitis, specifically limbic encephalitis, with CDD as a sequela. They explicitly waived any causation-in-fact argument, relying solely on the Table Injury presumption. The claim required proof of encephalitis with onset within 5-15 days of MMR or 72 hours of DTaP. The central issue was the interpretation of N.N.'s 2005 and 2011 MRI scans. Petitioners' expert, Dr. Robert Shuman, interpreted the MRIs as showing scarring from past encephalitis. Respondent's expert, Dr. Max Wiznitzer, argued the findings were normal developmental variants or artifacts, supported by medical literature. Special Master Hastings found Dr. Wiznitzer's interpretation more persuasive on all five alleged MRI abnormalities, concluding Petitioners failed to prove encephalitis. The Court of Federal Claims affirmed, deferring to the Special Master's credibility findings and expert evaluation. Attorneys for Petitioners: Curtis R. Webb. Attorneys for Respondent: Voris E. Johnson, U.S. Department of Justice. Special Master: George L. Hastings, Jr. Judge: Nancy B. Firestone. Decision Date: January 20, 2015 (Special Master), August 19, 2015 (Court of Federal Claims).","is_death":0,"date_of_death":null,"petition_filed_date":"2007-11-19","case_summary":"On November 19, 2007, Peter and Cherie Nuttall filed a petition on behalf of their minor son, N.N., alleging that N.N. developed Childhood Disintegrative Disorder (CDD) as a sequela of encephalitis caused by either the MMR or DTaP vaccination administered on November 22, 2004. N.N. was born on September 11, 2000. His early medical history was unremarkable, except for a note at approximately five months old of \"probable mild clonic jerking with transition to sleep phase.\" He received the DTaP, MMR, and inactivated poliovirus vaccines on November 22, 2004, with no documented adverse reaction. The first signs of regression, including speech and developmental delay, were noted in June 2005, with a diagnosis of CDD by Dr. Joan Carapucci. A CT scan in July 2005 and an MRI in November 2005 were interpreted as normal. In 2011, an MRI was performed, interpreted by Dr. Jose Bauza as showing abnormalities consistent with previous encephalitis. Petitioners amended their petition in November 2011, shifting their theory to a \"Table Injury\" claim, specifically post-vaccinal limbic encephalitis, arguing that N.N.'s CDD was a sequela of this encephalitis. They waived any causation-in-fact argument. A fact hearing was held in June 2008, and Special Master Christian Moran issued findings in March 2009, determining that N.N.'s language began to decrease in November 2004 and he experienced separation anxiety on November 30, 2004. The case was stayed pending the outcome of the Omnibus Autism Proceeding test cases. An expert hearing was held on January 25, 2013, before Special Master George L. Hastings. Petitioners presented Dr. Robert M. Shuman, a pediatric neurologist and legal consultant, and Respondent presented Dr. Max Wiznitzer, a pediatric neurologist. Both experts agreed N.N.'s clinical course was consistent with either CDD or limbic encephalitis. The case hinged on the interpretation of N.N.'s 2005 and 2011 MRI scans. Dr. Shuman identified five alleged abnormalities indicative of past encephalitis: trigonal hyperintensities, hippocampal hyperintensity, ventricle lining hyperintensity, enlarged ventricles, and fornix hyperintensity. Dr. Wiznitzer countered each of these points, arguing they represented normal developmental variants or MRI artifacts, supported by medical literature. Special Master Hastings found Dr. Wiznitzer's interpretations more persuasive, noting that Dr. Shuman's assertions were often unsupported by literature and that Dr. Shuman had retired from clinical practice in 2006. He also gave little weight to Dr. Bauza's report, finding it lacked independent reasoning and was influenced by Dr. Shuman. On January 20, 2015, Special Master Hastings denied compensation, finding that Petitioners failed to establish that N.N. experienced any brain inflammation. The Court of Federal Claims, Judge Nancy B. Firestone, affirmed this decision on August 19, 2015, deferring to the Special Master's credibility determinations and finding no arbitrary or capricious action in the evaluation of the evidence, including Dr. Bauza's report. The court found that Dr. Wiznitzer's testimony, supported by medical literature, was more persuasive.","is_minor_inferred":1,"is_pediatric_broad":1,"special_master":"George L. Hastings Jr.","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Curtis R. Webb","petitioner_attorney_firm":"Curtis R. Webb, Attorney at Law","petitioner_attorney_location":"Twin Falls, ID","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|curtis-webb|","firm_canonical_key":"curtis-r-webb","package_title":"NUTTALL et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_07-vv-00810","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_07-vv-00810.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_07-vv-00810.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_07-vv-00810-0","title":"NUTTALL et al v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 01/20/2015) regarding 100 DECISION of Special Master. Signed by Special Master George L. Hastings. 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